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Hemorrhoidal pain is primarily treated by Zanzhu (BL2,攒竹). Hemorrhoids are primarily treated by Huiyin (CV1,会阴). Cases where hemorrhoids communicate with the yin region are fatal. For various diseases of the yin region, involving mutual pulling pain between the anterior and posterior orifices, and inability to urinate or defecate, these acupoints are primarily used. Bone erosion caused by hemorrhoids is primarily treated by Shangqiu (SP5,商丘). Hemorrhoids and perineal pain are primarily treated by Feiyang (BL58,飞扬), Weizhong (BL40,委中), and Chengfu (BL36,承扶). Hemorrhoids and anal pain are primarily treated by Chengjin (BL57,承筋). Rectal prolapse is primarily treated by needling Qichuan (ST30,气街).

The Yellow Emperor asked: When Zhou Bi (Zhou-type Bi syndrome) occurs in the body, it migrates up and down, following the meridians, corresponding left and right, with no space in between. I wish to know if this pain lies within the blood vessels or between the muscle layers? How does it arise? When the pain shifts, there is not enough time to insert the needle; when the pain accumulates, there is not enough time to determine treatment before the pain ceases. What is the reason for this? Qibo replied: This is Zhong Bi (Zhong-type Bi syndrome), not Zhou Bi. Zhong Bi occurs at specific locations, alternating between onset and cessation, appearing and disappearing, with left corresponding to right and right to left. It does not circulate throughout the body but alternates in发作 and rest. To treat this, even if the pain has ceased, one must needle the site where the pain occurred to prevent recurrence.

The Yellow Emperor asked: What about Zhou Bi? Qibo said: Zhou Bi resides within the blood vessels, moving up and down along the meridians, without spreading left or right, affecting specific areas. If the pain moves from above downwards, first needle the lower part to unblock the flow (or to restrain it), then needle the upper part to release the pathogen; if the pain moves from below upwards, first needle the upper part to unblock the flow, then needle the lower part to release the pathogen. The Yellow Emperor asked: How does this disease originate, and why is it named so? Qibo said: Wind, cold, and dampness pathogens lodge between the muscle layers, pressing on fluids to form foam. When the foam encounters cold, it aggregates; aggregation pushes apart the muscle layers causing separation, which results in pain. When pain occurs, the spirit concentrates on the area; concentration generates heat; heat resolves the pain; resolution leads to Qi reversal; reversal causes other Bi syndromes to erupt, thus continuing the cycle. This disease is neither internal to the Zang organs nor external on the skin, but resides solely between the muscle layers, preventing the True Qi from circulating fully, hence named Zhou Bi. Therefore, to treat Bi syndrome, one must first palpate and examine the major meridians above and below, assess deficiency and excess, and regulate cases of blood stasis in the large collaterals or deficient, sunken pulses. Use moxibustion or hot compresses to unblock the channels, and apply guiding exercises for muscle tension.

The Yellow Emperor asked: How can one identify those prone to Bi syndrome? Shaoyu replied: Those with coarse texture and weak muscles are prone to Bi syndrome. To determine the location, observe the upper, middle, and lower regions. The Yellow Emperor asked: Why are there three variations in needling? He replied: There is needling of Ying (Nutrient) level, Wei (Defensive) level, and Cold Bi lodged in the meridians. Needling Ying releases blood; needling Wei releases Qi; treating Cold Bi induces internal heat. The Yellow Emperor asked: What are the manifestations of Ying, Wei, and Cold Bi diseases? He replied: Ying disease manifests as chills, fever, shortness of breath, and abnormal movement of blood up and down. Wei disease manifests as fluctuating Qi and Blood, oppression and distension, with wind-cold lodging in the stomach and intestines. Cold Bi manifests as persistent pathogen retention, intermittent pain, and numbness of the skin. The Yellow Emperor asked: How to induce internal heat when needling Cold Bi? He replied: For commoners, use fire-quenching (fire needle); for nobles, use medicinal hot compresses. The prescription uses 20 sheng of strong wine, 1 sheng of Shuzao (Sichuan pepper), 1 sheng of Ganjiang (Dried ginger), and 1 sheng of Guirou (Cinnamon bark). These four herbs are finely chopped and soaked in clear wine. Add 1 jin of cotton wadding and 42 chi of fine white cloth into the wine. Place the container in horse manure fire, seal tightly to prevent gas leakage. After five days and nights, remove the cloth and wadding, dry them in the sun, and re-soak to extract all juice. Each soaking must be followed by drying on a suitable day. Finally, cut the cloth and wadding mixed with dregs into six towels of 6-7 chi length. Heat the towels over live charcoal of mulberry wood and apply hot compresses to the Cold Bi affected areas, allowing heat to penetrate the lesion. Repeat heating and application thirty times until sweating occurs. Wipe the body with the heated towel thirty times. Then walk indoors, avoiding wind. Apply hot compress after every needling session. This resolves the disease and constitutes "internal heat."

The Yellow Emperor asked: How does Bi syndrome arise? He replied: Wind, cold, and dampness combine to form Bi. Dominance of Wind creates Xing Bi (Wandering Bi). Dominance of Cold creates Tong Bi (Painful Bi). Dominance of Dampness creates Zhuo Bi (Fixed Bi). The Yellow Emperor asked: What are the five types? He replied: Contracted in winter, it becomes Gu Bi (Bone Bi); in spring, Jin Bi (Tendon Bi); in summer, Mai Bi (Vessel Bi); during the late summer (Zhi Yin), Ji Bi (Muscle Bi); in autumn, Pi Bi (Skin Bi). The Yellow Emperor asked: How do pathogens enter the Zang and Fu organs? He replied: Each Zang organ has its associated tissue. If the disease persists, the pathogen enters the associated tissue. Thus, if Gu Bi persists and re-exposure occurs, it enters the Kidney; if Jin Bi persists, it enters the Liver; if Mai Bi persists, it enters the Heart; if Ji Bi persists, it enters the Spleen; if Pi Bi persists, it enters the Lung. Bi syndromes arise from contracting wind-cold-dampness in their respective seasons. Untreated Bi may progress internally. Cases with dominant Wind are easier to cure. The Yellow Emperor asked: Why do some die, some suffer long-term pain, and some recover easily? He replied: Pathogens entering the Zang lead to death; those lingering in sinews and bones cause prolonged pain; those in the skin recover easily. The Yellow Emperor asked: What about pathogens lodging in the Fu organs? He replied: Diet and lifestyle are the root causes. Each Fu organ has Shu points; wind-cold-dampness attacks these points, and dietary responses allow pathogens to enter via the Shu points and lodge in the respective Fu organs. The Yellow Emperor asked: How to treat with needles? He replied: Zang organs have Shu points, Fu organs have He-Sea points. Following the meridian pathways and treating the affected sites will cure the disease. The Yellow Emperor asked: Can Ying and Wei Qi cause Bi syndrome? He replied: Ying Qi is the essence of water and grain, harmonizing the Zang organs and distributing to the Fu organs, entering the vessels to circulate through the Zang and connect the Fu. Wei Qi is the fierce Qi of water and grain, moving rapidly and smoothly, unable to enter the vessels. It circulates in the skin and muscle layers, steaming the Huang membrane and dispersing in the chest and abdomen. If its flow is reversed, disease occurs; if smooth, health is maintained. Since it does not combine with wind-cold-dampness, it does not form Bi syndrome.